Inpatient falls can lead to injury, prolonged stays, lack of patient independence, and additional resource expense. The long-term goal of this program of research is to understand factors that contribute to falls and to develop and test interventions to prevent them. Little research has been done on the nursing staff's response time to patient call lights as it contributes to predicting patient falls. This project extends the PI's preliminary findings on the risk factors for inpatient falls, and specifically on the relationship of the call light usage and response time to falls and patient satisfaction. The specific aims of this proposed study are to examine the unique contribution of call light response time in predicting: 1) total fall rates, 2) injurious fall rates, and 3) patients'perceptions about call light responsiveness. We will analyze data from 32 units from four Michigan hospitals (three teaching hospitals and one community hospital) using archived hospital data/reports from January 2002 to December 2008. Data will be abstracted from the archived hospital data/reports and multiple regression analyses will be used to address the following hypotheses: H1) Call light response time will contribute significantly to predicting fall rates. H2) Call light response time will contribute significantly to predicting injurious fall rates. H3) Call light response time will contribute significantly to predicting patients'perceptions about call light responsiveness. The dependent variables are the total fall rate, injurious fall rate, and patients'perceptions about call light responsiveness. The primary independent variable is call light response time. The control variables are the hospital, unit type, call light use rate, total nursing hours per patient-day (HPPDs), and percent of the total nursing HPPDs supplied by RNs. For the regression analyses, the patient care unit-month will be the unit of analysis defined as data aggregated by month for each patient care unit. The sample size (N=2688) will provide adequate statistical power. Findings from this multi-hospital study design will increase the understanding of the relation between staff response time to call lights and falls and patient perceptions in multiple adult inpatient acute care units and will lay the foundation for future descriptive and intervention studies. The long-term goal is to promote safer hospital stays for inpatients, including fewer inpatient falls and fall injuries.